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目的明确人感染禽流感疫情,查明其感染来源,采取有效措施控制疫情。方法采用现场流调和实验检测相结合的方法对萍乡市1例儿科门急诊发热病例进行筛查、诊断和分析。结果该患儿女性,4岁,于2016年8月2日开始发病,病初表现为流感样症状,反复高热2天,在家口服抗生素等药物治疗无效于2016年8月4日晚上来院就诊,经过抗病毒等有效治疗于2016年8月12日痊愈。患儿咽拭子标本禽流感病毒(H9N2)核酸阳性,病毒分离阳性,基因系列分析显示,分离的H9N2病毒[A/Jiangxi/1/2016/(H9N2)]仍为禽源性特征。患儿发病前后未离开过居住地,未接触过类似病人,但发病近2周有禽类及产品接触史。经医学观察一周,所有密切接触者(包括患儿直系家属共58人)均未出现类似症状。参照卫生部禽流感防控应急预案,采取相应防控措施,疫情没有扩散。结论该病例确诊为江西省首例人感染低致病性禽流感,感染来源可能是禽流感病毒(H9N2)从家禽中获得,无人传人的现象。该例患儿是在我院作为国家流感监测哨点医院日常监测工作中被发现,提示今后应继续加强流感疫情监测工作,加强人感染禽流感的应急贮备、培训和健康宣教。
Objective To clarify the human infection of bird flu, identify the source of infection and take effective measures to control the outbreak. Methods One case of fever in pediatric emergency department in Pingxiang was screened, diagnosed and analyzed by a combination of field flow test and laboratory test. Results The females, aged 4, started to develop symptoms on August 2, 2016 with flu-like symptoms at the beginning of the illness. Repeated hyperthermia for 2 days was ineffective at home with oral antibiotics and other drugs. The hospital was visited on the night of August 4, 2016, After effective treatment such as antivirus on August 12, 2016 heal. Children with throat swab specimens were positive for avian influenza A virus (H9N2) and positive for virus isolation. Gene series analysis showed that the isolated H9N2 virus [A / Jiangxi / 1/2016 / (H9N2)] was still avian characteristic. Before and after the onset of children did not leave the place of residence, had not been exposed to similar patients, but the incidence of nearly 2 weeks history of contact with birds and products. One week after the medical observation, no similar symptoms were found in all close contacts (including a total of 58 immediate family members). With reference to the bird flu prevention and control emergency plan of the Ministry of Health, corresponding prevention and control measures were taken and the epidemic did not spread. Conclusions This case was diagnosed as the first human case of low pathogenic avian influenza in humans in Jiangxi Province. The source of infection may be the uninfected human bird flu virus (H9N2) obtained from poultry. The case was found in our hospital as a routine surveillance of national influenza surveillance sentinel hospitals, suggesting that we should continue to strengthen the surveillance of influenza outbreak in the future and strengthen emergency stocking, training and health education of people infected with bird flu.